Most Troublesome Drugs in the Pharmacy

Every year millions of Americans are seriously harmed by the medicines that are supposed to heal them or relieve their discomfort. In far too many cases, the injuries are disabling or even fatal. The Institute for Safe Medication Practices [ISMP] has been tracking the FDA’s database of adverse drug reactions for years. ISMP is a “nonprofit organization devoted entirely to medication error prevention and safe medication use.”

Patients, pharmacists, physicians, nurses and drug companies can submit adverse event reports or stories about drug failures to the FDA through a system called MedWatch: After someone sends in a report of a bad drug reaction it ends up in a computerized database called AERS (Adverse Event Reporting System). The FDA reviews this information but doesn’t make it easily accessible in a usable form for the rest of us. That’s where Tom Moore comes in. He has cracked the FDA’s code and has been offering quarterly reports of the FDA data for years through ISMP.

If it weren’t for Tom we would have very little idea what kind of drug problems have been reported to the FDA. He has summarized the data for last year in his latest report: http://www.ismp.org/QuarterWatch/default.aspx

Here is what Tom has discovered. Adverse event reports of “serious, disabling, and fatal adverse drug events” are up over 9% in the last year. Roughly 180,000 such reports were submitted to the FDA. Experts estimate that is just the tip of the iceberg. It might represent as little as 1% of the number of people who were seriously harmed by medications last year. That’s because most health professionals cannot take the time to submit a report and most patients don’t know that they can.

The brand new report from ISMP uncovers the drugs that led to the most reports of serious adverse reactions in 2011. They are in order:

“Suspect drugs ranked by number of direct reports to FDA in 2011”

Pradaxa (dabigatran)

Coumadin (warfarin)

Levaquin (levofloxacin)

Carboplatin

Zestril (lisinopril)

Cisplatin

Zocor (simvastatin)

Cymbalta (duloxetine)

Cipro (ciprofloxacin)

Bactrim (sulfamethoxazole-trimethoprim)

Most health professionals would understand why Pradaxa and warfarin led the list. These anticoagulants are prescribed to prevent blood clots from causing strokes or other harm from restricted blood flow to vulnerable tissues. The trouble is that older patients are especially vulnerable to complications from such drugs. We think of it a bit like walking a tightrope. On one side are blood clots that can cause lethal complications. On the other side is hemorrhage that can lead to fatal bleeding episodes.

According to the ISMP report, Pradaxa was associated with hemorrhage, kidney failure, stroke, liver failure and more than 500 deaths. Warfarin was linked to over 1000 cases of serious complications and 72 deaths. These are just the serious adverse drug events for these two medications that were reported to the FDA. Goodness knows how many life-threatening or fatal reactions went unreported.

Most physicians would be surprised to see that the antibiotic Levaquin made the top 10 list of problem drugs. We’re not. We have received a huge number of complaints about this drug from visitors to this website. Many people report tendon problems. Here is just one example:

“My husband took Levaquin for a sinus infection and within hours the tendons in his legs tightened and he could not walk. It took months for him to get better though he still has some residual leg pain.”

Others report psychological or neurological problems with this class of antibiotics (fluoroquinolones): One visitor to this website shared this story:

“I am a college student who is still suffering the effects of Levaquin months later. My doctor prescribed it for painful urination with a fever. Within an hour of taking the first dose, my legs felt numb and it seemed like my brain was frying. I couldn’t explain to my mom what was happening and I could barely move. It wasn’t that I was paralyzed; more like I was walking on a water bed. I had no balance, my gait was terrible, and I couldn’t think.

“My doctor thought the neurological symptoms I was experiencing were due to fever and dehydration, but really it was a consequence of the Levaquin. I still have deep pains in my knees and feet and I am too weak to exercise as I used to. But the biggest problem that bothers me is the brain fog. I get lost easily, cannot remember things and had to withdraw from school. I am wired-tired and have great trouble sleeping.”

Most physicians would probably be amazed to see that lisinopril also made it to the top 10 list of problem prescriptions in 2011. Not us. We have been receiving a steady stream of serious complaints about this ACE inhibitor blood pressure medication for years. Here is just one example:

“Your column saved my life (or at least made it worth living again). I have been in lisinopril hell for over three months.

My insurance company switched me from Micardis, a blood pressure medicine that had no side effects, to lisinopril. They gave me six months free. If I had not agreed to switch, I would have had to pay $100 a month for the Micardis.

Almost immediately, I became incapacitated with a violent cough. It made me choke, gag and vomit, and even lose my bladder control.

“At first I thought I had caught the flu. A doctor then diagnosed a sinus infection. Antibiotics didn’t help. I went back to my doctor, who dismissed my symptoms by sending me to an allergist.

“The allergist had me fill out a lengthy history in which I mentioned the lisinopril, but he did not make the connection either. Instead he put me through a series of very expensive breathing tests and gave me breathing medicines (also expensive). Needless to say, none of this worked.

“I was becoming depressed because the cough was interfering with my sleep, work and social life. Then my neighbor showed me your column about lisinopril cough. I stopped the drug and have completely recovered.”

Some people experience a life-threatening allergic reaction to ACE inhibitors like lisinopril:

“On January 15, my brother experienced an allergic reaction that made his throat and tongue swell. He was rushed to the nearest emergency room, but shortly after he arrived his airways closed up so the ER staff could not get a tube in for some time.

“His wife had brought in his meds and it was quickly determined that the culprit was the blood pressure pill lisinopril. He had been been taking it for four years.

“He went into cardiac arrest and was revived but suffered massive brain damage. He died February 8. You might want to warn your readers about this reaction.” https://www.peoplespharmacy.com/2012/03/05/blood-pressure-pill-proved-deadly/

We must emphasize that NO ONE should EVER stop taking any medication without careful consultation with a physician and medical supervision. Even dangerous drugs can be essential for health. We have listed these medications because we believe that the ISMP report deserves careful consideration. Recognizing the drugs that have caused the most adverse event reports to the FDA may help patients avoid becoming a statistic or ending up in the FDA database. Always find out what symptoms to look out for. Have your health professionals fill out this FREE Drug Safety Questionnaire.

And take a few minutes to review the latest ISMP Quarter Watch. It provides far more depth about the FDA’s MedWatch reports than we can in this brief summary.

32 Thoughts Shared

SteveB

October 1, 2013 at 10:27 pm

My experience with Levaquin. Was prescribed Levaquin 750mg for 7 days for Sinusitis that a Z-Pac had failed to cure. Day 3 of the Levaquin and terrible itching over entire body. Called GP who told me to stop taking it and start on Benadryl as an antihistamine to quell the itching. Next morning lump in throat and constant belching and hiccupping. This developed to where a sip of water or any solid food was swallowed an immediate stabbing pain was felt in right upper chest, right ribs and around to right upper back.
This continued all day and the next morning and now included regurgitating any liquid that was drank. A trip to the ER where it was diagnosed that the Levaquin had affected my Esophagus and I was experiencing Esophagial Spasms.
They lasted several days and gradually subsided. It is now 7 days since the last pill was taken and the itching is decreasing slowly but still need the antihistamines. Worst week of my life and at 59 that’s saying something! Be very careful if offered this antibiotic!!

Pat P.

August 29, 2013 at 10:58 am

Dear Joe and Terry,
First let me say how valuable I find your show. Secondly, I would like to tell you about my experience with fever blisters.
For several years I was plagued with fever blisters around my mouth due to sun and stress. These were controlled with Acyclovir.
Two years ago my dentist recommended Sensodyne Pronamel toothpaste for my sensitive gums. It took me a while to notice the fever blisters completely stopped!
Recently I started taking a variety of vitamin supplements and the dreaded itchy signal of a fever blister recurred.
Is the toothpaste the reason the blisters stopped, and could a vitamin supplement re-start them?
Thanks so much!
PEOPLE’S PHARMACY RESPONSE:
We honestly do not have an answer to this question. Some folks do complain that the SLS ingredient in many toothpastes triggers the problem. Perhaps by switching brands you eliminated SLS.

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